Current pain and headache reports
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This article reviews the less frequently encountered varieties of migraine. It is suggested that these disorders be approached by evaluating possible underlying etiologies before positively diagnosing migraine. This decreases the likelihood of "missing" structural or metabolic disorders. The classification, diagnostic evaluation, differential diagnosis, and treatment options of these disorders is reviewed and a selection of references appended for additional information.
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Curr Pain Headache Rep · Jun 2002
ReviewThe role of a pharmacist in ambulatory cancer pain management.
Cancer pain is progressive and complex. The multidimensional character of cancer pain requires comprehensive management by a multidisciplinary team of health care professionals. ⋯ Pharmacists who are engaged in ambulatory cancer pain management can play a pivotal role in the pharmacotherapy of cancer pain by optimizing medication therapy, monitoring outcomes, enhancing adherence through patient education regarding drug use, pain and symptom control, educating other health professionals and students, and conducting research. To fully meet the therapeutic challenges of cancer pain, pharmacists need to improve their knowledge and attitudes about cancer pain and pain medications.
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Idiopathic intracranial hypertension (IIH) is a disorder of increased intracranial pressure that may have papilledema with normal imaging study results. Headache is the most frequent symptom. Although the headache characteristics are indistinguishable from the symptoms of migraine headache, accompanying symptoms of increased intracranial pressure, such as pulsatile tinnitus, transient visual obscurations, and radicular neck pain, may aid in the diagnosis. ⋯ Medical treatment for the headache includes weight loss for obese patients, diuretic therapy, and migraine preventive medications. If medical therapy does not abolish the headache, surgical options should be considered. Because patients with IIH have a poor quality of life, patient education and supportive materials are important.
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Cancer pain is a significant problem despite the advent of the World Health Organization's cancer pain guidelines, the US government's cancer pain guidelines, and the Joint Commission's mandate for hospital pain evaluation and treatment. Ninety percent of patients with cancer pain can be effectively treated with oral conservative medications. The remaining 10% need more invasive treatments to control their pain. This article reviews current methods of controlling cancer pain using intrathecal catheters, nerve blocks, and neurosurgical procedures.
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It is estimated that 40% to 50% of patients with metastatic disease and 90% of patients with terminal cancer experience unrelieved pain. Furthermore, inadequate treatment of cancer pain is a greater possibility if the patient is a substance abuser. In this paper, we will explore pertinent conceptual and clinical aspects of addiction that can assist in improving the identification and treatment of patients with substance use disorders.